Page 22 - Hoag Orthopedic Institute 2018 Outcomes Report

VALUE
BUNDLED PAYMENTS VS. FEE-FOR-SERVICE: CONCEPT BUNTDraLdEitDionPaAl FYeMe-EfoNr-STervice
Bundled payment refers to a model of care in
which a single payment for a particular procedure
covers all hospital and physician services. HOI’s
Bundled Payment Program is designed to help
the payor, hospital teams, physicians and patients work together to improve quality of care and better manage growing costs.
Bundled payment requires an integration of care
Providers
model for several years to enable transparency
MEDICARE’S COMPREHENSIVE CARE FOR JOINT REPLACEMENT (CJR)
The CJR bundled payment program is for patients who have a lower extremity joint replacement
– hip, knee or ankle – and includes elective primary or non-elective hip fracture where a joint is replaced. Any patient having a lower extremity joint replacement and who has Medicare
part A and part B will be included in the CJR program. Approximately 100 patients per month participated in the CJR program in 2017 at HOI.
Participating providers work together to bring standards of care in line with what has been proven to work best for patients with joint replacement, and have the flexibility to adjust care plans to each individual’s needs. Both the patient and caregiver take an active role in planning, decision-making and preparation prior to surgery through the return home and beyond. This reduces the risks of complications from surgery, which in turn helps improve care and reduce unnecessary costs.
and predictability of costs before surgery.
Patient
and alignment of physicians with their hospitals, physicians, therapists and skilled nursing facilities to achieve superior, affordable outcomes for patients. HOI has pioneered and utilized this payment
Payer
ONE OF THE NATION’S BEST HIP/ KNEE HOSPITALS FOR PRICING
Six years of CMS data demonstrates that patient-centered care and adherence to evidence-based standards of care lead to lower readmission rates. Based on CMS data published in the January 2018 editions of Orthopedics This Week and Becker’s Hospital Review, HOI provides
the highest value to patients. HOI was the No. 1 hospital on the list of the 17 top hip/knee hospitals with best pricing.
www.beckershospitalreview.com/finance/cms- releases-preliminary-cjr-program-results-7- things-to-know.html
19 | HOAG ORTHOPEDIC INSTITUTE
Example of Bundled Payment
Bundled Payment
Patient
Providers
Payer